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PELICAN DELIVERY PHARMACY
RWI70072 PRIORITY HEALTH CARE
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Covered Entity Details
Entity Name
PRIORITY HEALTH CARE
Subdivision Name
Type
Ryan White Part A
340B ID
RWI70072
Entity Address
4700 Wichers Drive
304-305
Marrero, LA 70072
Grant Number
H89HA00035
Participating Start Date
7/1/2011
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PELICAN DELIVERY PHARMACY
Pharmacy Address
909 AVENUE C
MARRERO, LA 70072-3123
Pharmacy Comments
Contract Details
Approval Date
1/15/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/31/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
FRAN LAWLESS, DIRECTOR MAYOR'S OFFICE OF HEALTH POLICY & AIDS
(504) 658-2804
Contract Pharmacy Representative
Erica M. Thompson, Pharmacist In Charge
(504) 341-0800
Signed By Date
1/15/2015
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